Why might friendships change or fade after a stroke?

Details

People are known to lose friends after a stroke, but the reasons are less well understood. This study explored why people lose contact with friends, what might protect friendships, and how individuals perceive friendship loss and change.

Researchers recruited 29 people who had experienced a first stroke from one acute stroke unit in the UK; 10 had aphasia. They conducted in-depth qualitative interviews between 8 and 15 months after the stroke.

The main reasons participants gave for losing friends were loss of shared activities, reduced energy levels, physical disability, aphasia, unhelpful responses from others, environmental barriers and changing social desires. Those who experienced the most extensive loss described a sense of ‘closing in’ on themselves, withdrawing from social contact and newly preferring to meet only close friends and family.

Participants with aphasia experienced the most hurtful negative responses from others and found it harder to retain friends unless they had strong, supportive friendship patterns before the stroke. Factors that helped protect friendships included a shared history, friends who showed concern or lived locally, friendships not based on activities, and having a friends-based social network before the stroke.

Given the link between depression and loss of friends after stroke, the authors suggested that supporting people in maintaining a social network is likely to be beneficial. They noted that effective intervention may need to consider changing social desires as well as the effects of new physical and language disabilities.